Cases reported "Nasopharyngeal Neoplasms"

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1/72. Epignathus: a germ-cell tumour presenting as neonatal respiratory distress.

    A full-term neonate developed acute upper airway obstruction immediately after birth secondary to a polypoidal mass in the oropharynx. After the child's airway had been secured, the mass was excised and found to be a nasopharyngeal teratoma, a rare congenital germ cell tumour which is frequently associated with other congenital malformations. It is sometimes possible to diagnose these tumours in utero, thereby enabling appropriate precautions to be taken during the delivery, otherwise if the diagnosis is unknown, then it is essential for any attending clinician to urgently secure the airway by means of either intubation or tracheostomy. Such a case is presented with a review of the possible management options. This case emphasises the fact that although many conditions are uncommon, the total incidence of rare conditions is surprisingly high, and that care needs to be taken at all times in the management of patients, in order not to overlook such life-threatening diagnoses.
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keywords = airway obstruction, obstruction, airway
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2/72. Epithelial-myoepithelial carcinoma arising in the nasal cavity: a case report and review of literature.

    Epithelial-myoepithelial carcinoma is an uncommon, low-grade, malignant epithelial neoplasm composed of variable proportions of ductular cells and large, clear staining, myoepithelial cells arranged around the periphery of the ducts. About 120 cases have been reported in the world literature, most of which were located in salivary glands, except for a few cases occurring in unusual locations such as breast, lacrimal gland, nose, paranasal sinus, trachea, bronchus, and lung. We here reported the second case of epithelial-myoepithelial carcinoma of the nasal cavity with extension to the nasopharynx. The patient was a 61 year old Chinese female with two month's history of progressive nasal obstruction. Histopathologically, the tumor showed typical myoepithelial and ductal cells biphasic differentiation, duct-like structure and infiltrating growth pattern. Some ductal cells showed the characteristics of oxyphilic cell, which had never been reported before. recurrence and metastasis rates of epithelial-myoepithelial carcinoma varied from 35% to 50% and 8.1% to 25% respectively in different reports. The present case had neither recurrence nor metastasis twenty months after operation. When epithelial-myoepithelial carcinoma is mainly composed of spindle myoepithelial cells, the differential diagnosis should include myoepithelioma, neurofibroma, leiomyoma and hemangiopericytoma.
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ranking = 0.080445185083182
keywords = obstruction
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3/72. Pituitary adenomas with infra-sellar extension into the nasopharynx.

    Three cases of pituitary adenomas with infra-sellar extension into the nasopharynx and the nasal cavities are reported. The clinical signs were epistaxis, nasal obstruction, painful sinuses and purulent rhinorrhoea. The initial diagnostic hypothesis was that of a carcinoma of the nasopharynx or the sinuses in all three cases. The diagnosis was made by histological examination and measurement of plasma hormone levels. These cases highlight the difficulty in the diagnosis of such tumours due to their misleading clinical, radiological and histological features.
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ranking = 0.080445185083182
keywords = obstruction
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4/72. Dermoid (hairy polyp) of the nasopharynx.

    Dermoids or hairy polyps, the most primitive forms of teratoma are rare lesions affecting the nasopharynx. They arise during early embryogenesis, being derived from only two germinal layers, ectoderm and mesoderm and are invariably benign. They usually present at or soon after birth with signs of upper aerodigestive tract obstruction. A case of hairy polyp of nasopharynx in a neonate is reported for its rarity. The etiology of teratomas, their classification in head and neck region, clinical features, and management in neonates are discussed.
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ranking = 0.080445185083182
keywords = obstruction
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5/72. Nasopharyngeal teratomas and dermoids: a review of the literature and case series.

    OBJECTIVES: review the clinical differences between nasopharyngeal (NP) true teratomas and dermoids, with the addition of a case series to the literature. Additionally, review the impact of prenatal diagnosis on the management and outcome of these lesions. STUDY DESIGN: Retrospective review of cases from the Children's Hospital Medical Center (Seattle, WA) and Madigan Army Medical Center (Tacoma, WA) with the histopathologic diagnosis of nasopharyngeal teratoma or dermoid. review of medical literature for cases reported since 1977, when prenatal diagnosis of these lesions was first reported. Only tumors of the nasopharynx were considered. methods: charts and pertinent literature were reviewed and data presented with respect to age at diagnosis, signs and symptoms, perinatal diagnosis and management, preoperative evaluation, surgical treatment, and outcome. RESULTS: The majority of lesions were diagnosed at birth, with the most common presenting symptom being respiratory distress. Teratomas had a higher incidence of maternal polyhydramnios, preterm birth, need for emergent airway management, and associated congenital abnormalities. Complete surgical excision remains the treatment of choice. Recurrences were rare, occurring only in the teratoma group. prenatal diagnosis did not have a significant impact on the diagnosis and treatment of these lesions in our review. CONCLUSIONS: Inconsistent use of a standard classification system has made differentiating between NP teratomas and dermoids difficult, although the clinical implications can be critical. NP teratomas have a higher incidence of preterm birth, neonatal airway distress, associated congenital abnormalities, need for more extensive surgical procedures, and recurrence. prenatal diagnosis has made little impact on the overall diagnosis and treatment of these lesions.
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ranking = 0.090779488943387
keywords = airway
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6/72. Upper airways locations of plasmocytoma.

    We report one case of extramedullary plasmocytoma located in the nasopharynx. After 8 years, the tumor recurred in the same location and 3 years later, the patient develop a multiple myeloma. Three clinical and pathological entities of plasmocytoma are described: multiple myeloma, solitary bone plasmocytoma and extramedullary plasmocytoma. When histological examination show plasmocytoma, further examinations can or not reveal a multiple myeloma. In 80% of cases, extramedullary plasmocytoma occur in the upper respiratory tract. This development of multiple myeloma from extramedullary plasmocytoma is seen in 5 to 32% of patients and sometimes an extremely long time is required for the change to occur. The treatments are surgery and radiation in the absence of generalized disease.
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ranking = 0.18155897788677
keywords = airway
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7/72. Nasopharyngeal cancer and the Southeast Asian patient.

    Because of a documented increased incidence, nasopharyngeal cancer should be considered when signs or symptoms of ear, nose and throat disease are present in patients from southern china (in particular, hong kong and the province of Guangdong) or Southeast asia. Environmental factors, the Epstein-Barr virus and genetic factors have been associated with the development of nasopharyngeal cancer. patients with this malignancy most often present with a cervical mass from metastatic spread to a lymph node. Other possible presentations include ipsilateral serous otitis, hearing loss, nasal obstruction, frank epistaxis, purulent or bloody rhinorrhea, and facial neuropathy or facial nerve palsies. radiotherapy is often curative. The addition of chemotherapy has produced high response rates in local and regionally advanced disease.
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ranking = 0.080445185083182
keywords = obstruction
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8/72. Nasopharyngeal epignathus causing nasal airway blocking in a 4-year old child.

    Congenital oral teratoma or epignathus is a very rare lesion, especially in older children. We report on a 4-year old female infant presenting with nasal blocking, little watery discharge and recurrent otitis. First adenoids were suspected. An endoscopic examination of the nose and nasopharynx demonstrated an irregular mass in the nasopharynx, covered partly by mucosa. A MRI-scan (T1-weighted) showed fat-intensity. Histological examination revealed a teratomatous malformation. Although rare, teratoma should be included in the differential diagnosis of a nasopharyngeal mass in the paediatric age group.
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ranking = 0.18155897788677
keywords = airway
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9/72. Upper respiratory tract carcinoma with chromosomal translocation 15;19: evidence for a distinct disease entity of young patients with a rapidly fatal course.

    BACKGROUND: carcinoma of the upper respiratory tract is rare in childhood, and cytogenetic aberrations have not been characterized in this population. The chromosomal translocation 15;19 has been reported four times previously. All patients were young and had tumors arising in the thorax. The three reports that provide clinical follow-up all describe superior vena cava syndrome and death soon after presentation. All tumors were diagnosed as carcinoma (three undifferentiated, one mucoepidermoid), and the authors suggested thymus, lung, or germ cell origin. methods: The authors investigated the clinical and pathologic findings in two patients with poorly differentiated carcinoma showing evidence of t(15;19). This included a 13-year-old girl with a rapidly growing epiglottic mass, leading to superior vena cava syndrome and death and a 12-year-old girl with an aggressive nasopharyngeal mass showing intracranial extension. RESULTS: The laryngeal tumor was poorly differentiated, with vesicular nuclei, prominent nucleoli, extensive necrosis, and a lymphoplasmacytic infiltrate; cells were positive for cytokeratin and negative for lymphoma, melanoma, germ cell, and endocrine markers. Electron microscopy showed rare intermediate junctions and basal lamina. The nasopharyngeal tumor was poorly differentiated with areas of obvious squamous differentiation observed histologically, immunophenotypically, and ultrastructurally. Cytogenetic and fluorescent in situ hybridization studies were consistent with t(15;19)(q13;p13.1) in both cases. Both children received chemo- and radiotherapy. The first child died of disease after 36 weeks; autopsy revealed tumor in the larynx with spread to the skin/subcutis (neck and thorax) and lymph nodes (cervical, subcarinal, and pulmonary hilar). The second child developed widespread bony metastases and died of disease after 13 weeks. CONCLUSIONS: In conjunction with previous reports, the authors' findings show that t(15;19) is part of a distinct clinicopathologic entity characterized by young age, midline carcinoma of the neck or upper thorax, and a rapidly fatal course. female gender and superior vena cava syndrome are common. The histogenesis of these distinctive tumors is unknown. The authors' findings suggest origin in the upper airway, perhaps from submucosal glands.
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ranking = 0.045389744471694
keywords = airway
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10/72. Burkitt's/Burkitt's-like lymphoma presenting as bacterial sinusitis in two hiv-infected children.

    Two children (ages 12 and 13 years) with transfusion-acquired human immunodeficiency virus (hiv) infection presented with facial pain and rhinorrhea. Radiographic imaging showed extensive paranasal sinus disease, presumed to be bacterial sinusitis, and the patients were treated with broad-spectrum oral antibiotics. Both patients were unresponsive to oral agents and were switched to intravenous antibiotics. Despite aggressive antimicrobial therapy, one patient (case 1) developed increased periorbital swelling and proptosis, and the other patient (case 2) developed symptoms of nasopharyngeal obstruction. Repeat imaging showed progression of the infiltrative process extending from the paranasal sinuses into the orbit (case 1), and nasopharynx (case 2). Surgical exploration and tissue biopsies were performed on both patients and the histopathology was consistent with Burkitt's/Burkitt's-like lymphoma. Combination systemic and intrathecal chemotherapy resulted in a complete remission in both patients. These reports illustrate the fact that Burkitt's/Burkitt's-like lymphoma in the paranasal sinuses may initially masquerade as an acute bacterial sinusitis. The ability of the tumor to extend rapidly from the sinuses into the orbit and nasopharynx reinforces the importance of early diagnosis and treatment. Burkitt's/Burkitt's-like lymphoma in the paranasal sinuses has not been previously described in hiv-infected children.
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ranking = 0.080445185083182
keywords = obstruction
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